Trauma patients should be treated with antifibrinolytics at the scene of injury, and post-partum haemorrhage should be treated as soon as the diagnosis is made, suggests new research.

The study, published in The Lancet, examined the impact of treatment delay on the effectiveness of antifibrinolytics in 40,138 patients from two randomised trials of tranexamic acid in acute severe bleeding due to trauma and post-partum haemorrhage.

It found treatment significantly increased overall survival from bleeding (odds ratio [OR] 1·20), with no heterogeneity by site of bleeding. Immediate treatment improved survival by more than 70 per cent. However, treatment delay reduced the treatment benefit, with survival decreasing by 10 per cent for every 15 minutes of treatment delay until three hours, after which there was no benefit.

"Responding quickly can be the difference between life and death, and that means patients must be treated urgently at the scene of injury or as soon as the diagnosis of haemorrhage is made. We have to make sure tranexamic acid is available before patients reach the hospital and whenever a woman gives birth," said Professor Ian Roberts from the London School of Hygiene & Tropical Medicine, UK, who initiated the study.